St. John's Addresses Needs of South LA Transgender Community

A multitude of stories have illustrated the scarcity, high cost and inadequate services in transgender health care, but it's imperative these conversations don't become an echo chamber. Access can be especially difficult for the transgender community, with 15 percent of the community reporting extreme poverty of less than $10K per year. �
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"Disparities that are faced by trans communities include social determinates of health like access to school, healthcare and safe and stable housing," said Queen Victoria Ortega, Trans Empowerment Case Manager. "However, unique to trans community disparities include: denial of lifelong needed hormone therapy, lack of job opportunities and discrimination in the workforce sector. Legislation is currently being considered in many states regarding bathroom use; yes, bathroom use. A simple human function is a point of social contention."
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St. John's Well Child and Family Center�observed the discrimination, degradation and cost of getting lifesaving treatment. Noticing their own community was suffering, they�created and implemented the Transgender Health Program (THP), the only Los Angeles community clinic with comprehensive transgender-focused program.�

"The barriers mentioned above contribute to trans people not accessing health services as it becomes an endless barrage of red tape,�harassing conversations and blatant abuse by a system not designed for us," added Ortega.
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St. John's recently released further research in a whitepaper called, "The Unmet Needs: Transgender Health in South Los Angeles,"�which features proposed national policy recommendations to improve access and care for transgender patients, including removing authorization for hormone therapy and implementing hormone therapy in lifetime insurance coverage.

"The mission of St. John's and the Transgender Health Program is to eliminate health disparities and foster community well-being by providing and promoting the highest quality of care in South Los Angeles," said Diana Feliz Oliva, MSW, Transgender Health Program Coordinator. "We achieve this by adopting a patient-centered model of care with no barrier or very little barrier to accessing health care. Also, sustaining long-term community health improvements by advocating health policy changes and recommendations. We see all patients regardless of ability to pay and documentation status."

Approximately 2,100 transgender individuals live in South Los Angeles alone and face high rates of discrimination, stigma and isolation in an area that is already disproportionately disadvantaged.�With the exponential growth of the transgender health program over the first year, the need came to develop additional services, such as hosting free Name and Gender Marker Change Clinics, educational presentations in the community, Trans*Empower (an economic and professional development program) and a focus on care coordination, case management and patient advocacy.�The focus is on comprehensive programs and services.

Some services include:�Hormone therapy; referrals for gender confirming surgeries; referrals to transgender advocates;�legal support;�primary and preventive care -- medical, dental, and pharmacy; behavioral health care; individual and family counseling; support groups; HIV and STI testing, counseling and treatment; health insurance enrollment assistance; and assistance with legal name/gender change paperwork.

Name and Gender Marker Change clinics serve to affirm our patient's identity to themselves and to the strangers that might ask to see their identification, noted Transgender Health Program Patient Advocate Adriel Rodriguez, explaining, "It serves to provide safer environments for our patients. Once the process is complete it allows our patients to live their life without having to answer questions about their identity to those who must see identification while looking for housing or employment."

As part of their cultural competency, all of the leadership and staff of St. John's Transgender Health Program are trans people, empowering their communities to advocate and lead the provision of services and action. They keep connected with transgender people, attend support groups within the community, and fight for their rights, keeping in mind race, class, gender identities, immigration status, able body privilege and generational differences.

"The mission of St. John's and the Transgender Health Program is to eliminate health disparities and foster community well-being by providing and promoting the highest quality of care in South Los Angeles," said Oliva. "We achieve this by adopting a patient-centered model of care with no barrier or very little barrier to accessing health care. Also, sustaining long-term community health improvements by advocating health policy changes and recommendations. We see all patients regardless of ability to pay and documentation status."

The Transgender Health Program at St. John's has changed the landscape of South Los Angeles by being the only Federally Qualified Health Center providing trans health care services. In addition, the program was created by transgender staff members for transgender patients. The Transgender Health Program is the only trans health care program in all of Los Angeles County that provides services for monolingual Spanish-speaking patients, specifically undocumented trans people of color.

The Transgender Health Program at St. John's is the only health care program that is fully trans-identified and bilingual, which enables them to better serve their patient population with sensitivity and provide culturally competent services. They continue to change the landscape of South Los Angeles by being a leader, catalyst and model of best care; long-term community health improvements; and sustainable, health-enhancing systems and structures.

"We have begun building transgender 'right to health committees' -- patient advocacy organizations to advance policy change and advance access and reduce disparities for the transgender community," said President and CEO Jim Mangia. "In less than a year of operation, St. John's has provided care to more than 500 transgender patients and each week, dozens more are accessing St. John's health centers."